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Bronchial Asthma - Epidemiology, Pathogenesis and ManagementShashikiran Umakanth
Bronchial asthma is a chronic disease with airway inflammation as a central theme in its pathogenesis. Prevalence of this condition is gradually increasing, especially in developed countries and in countries that are getting "westernized". With early diagnosis, regular monitoring and prompt and rational treatment, most patients with asthma can lead a symptom-free life.
Allergic disorders are on rise with increase in urbanization, improved personal hygiene & more people migrating in search of jobs, better opportunities. Diagnosis of allergy can aid the clinician is appropriate counselling of the patient for avoidance of specific allergens & if required prescribe appropriate immunotherapy.
Candida is the most common cause of fungal infection worldwide and 4th most common cause of blood stream infections in hospital setting.
Associated with 47 % mortality rate.
17 different species identified till yet.
Most common among them are C. albicans, C. glabrata, C. parapsilosis and C. tropicalis.
Candida usually develops on mucous membranes ( mouth , genitals etc).
Candida in blood stream it is known as candidemia.
When it passes from blood stream to other body parts(eyes, kidney, liver and brain etc) it is called invasive candidiasis.
Allergic disorders are on rise with increase in urbanization, improved personal hygiene & more people migrating in search of jobs, better opportunities. Diagnosis of allergy can aid the clinician is appropriate counselling of the patient for avoidance of specific allergens & if required prescribe appropriate immunotherapy.
Candida is the most common cause of fungal infection worldwide and 4th most common cause of blood stream infections in hospital setting.
Associated with 47 % mortality rate.
17 different species identified till yet.
Most common among them are C. albicans, C. glabrata, C. parapsilosis and C. tropicalis.
Candida usually develops on mucous membranes ( mouth , genitals etc).
Candida in blood stream it is known as candidemia.
When it passes from blood stream to other body parts(eyes, kidney, liver and brain etc) it is called invasive candidiasis.
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True Dialogue has been successfully tested by several businesses such as Produits forestiers Résolu and Talisman Energy. It is currently being used for certain confidential, large-scale projects in Quebec.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
The global radiation oncology market size reached US$ 8.1 Billion in 2023. Looking forward, IMARC Group expects the market to reach US$ 14.5 Billion by 2032, exhibiting a growth rate (CAGR) of 6.5% during 2024-2032.
More Info:- https://www.imarcgroup.com/radiation-oncology-market
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
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The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
LGBTQ+ Adults: Unique Opportunities and Inclusive Approaches to CareVITASAuthor
This webinar helps clinicians understand the unique healthcare needs of the LGBTQ+ community, primarily in relation to end-of-life care. Topics include social and cultural background and challenges, healthcare disparities, advanced care planning, and strategies for reaching the community and improving quality of care.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
Rate Controlled Drug Delivery Systems, Activation Modulated Drug Delivery Systems, Mechanically activated, pH activated, Enzyme activated, Osmotic activated Drug Delivery Systems, Feedback regulated Drug Delivery Systems systems are discussed here.
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
Empowering ACOs: Leveraging Quality Management Tools for MIPS and Beyond
Allergic reactions
1. ALLERGIC REACTIONS
(ANAPHYLAXIS)
This protocol is to be used for patients who may be
experiencing an allergic reaction. The reaction can be
triggered by contact with an object, substance, something
ingested or something injected beneath the skin (sting, bite,
IM, IV or SubQ medication or chemical, etc). The reaction
can range from a mild irritation and/or twitching (with or
without a rash) of a localized area of the skin/body, to a full
blown anaphylactic reaction with respiratory and
cardiovascular collapse.
3. MILD REACTIONS
BASIC LEVEL: EMT and PARAMEDIC
Initial Patient Assessment Protocol 2.1.1.
Airway Assessment /Management Protocol (O2 PRN) 2.1.2.
Attach cardiac monitor and pulse oximeter.
Transport to designated hospital.
ALS LEVEL 1: PARAMEDIC ONLY
Initiate IV of Lactated Ringers or Normal Saline at TKO.
Diphenhydramine HCL (Benadryl) 25mg IV or 50mg IM (Peds; 1-2mg/kg IV or IM.
Ranitidine (Zantac) 150mg PO if able to swallow.
ALS LEVEL 2: MEDICAL CONTROL
Call Medical Control or Medical Director for any concerns or help.
4. MODERATE ALLERGIC REACTIONS
(edema, hives, dyspnea, wheezing, “lump in throat” feeling, difficulty
swallowing, facial swelling and stable vital signs with a systolic BP> 90mmHg).
BASIC LEVEL: EMT and PARAMEDIC
Initial Patient Assessment Protocol 2.1.1.
Airway Assessment/Management Protocol 2.1.2.
Attach cardiac monitor and pulse oximeter.
Transport to designated hospital.
5. MODERATE ALLERGIC REACTIONS
cont.
ALS LEVEL 1: PARAMEDIC ONLY
Initiate IV Lactated Ringers or Normal Saline at 70cc/hr.
` Diphenhydramine HCL (Benadryl) 25mg IV or 50mg IM (Peds; 1-2mg/kg IV or IM.
Ranitidine (Zantac) 150mg PO (Peds; 2mg/kg PO).
Methylprednisolone Sodium Succinate (Solu-Medrol) 125mg IV/IO/IM.
Epinephrine (1:1000) 0.4mg IM Adult (Peds 0.01mg/kg). Caution should be used with
administration of Epinephrine when the patient has a history of hypertension or heart
disease. Call Medical Control if you have any concerns.
IF patient is on a Beta Blocker medication, administer Glucagon 2mg IV over 2-5
minutes. If you are not sure which drugs are Beta Blockers, contact Medical Control to
discuss.
If a patient shows signs of respiratory distress, administer;
Albuterol (Ventolin) 2.5mg mixed with 2.5ml of Normal Saline nebulizer treatment.
May repeat twice PRN.
Add Atrovent (Ipratropium Bromide) 0.5mg to the first Albuterol nebulizer treatment
only.
ALS LEVEL 2: MEDICAL CONTROL
Call Medical Control or Medical Director for any concerns or help.
6. SEVERE ALLERGIC
REACTIONS/ANAPHYLAXIS
(edema, hives, severe dyspnea and wheezing, unstable vital signs with systolic
BP < 90mm Hg, possible cyanosis and/or laryngeal edema).
BASIC LEVEL: EMT and PARAMEDIC
Initial Patient Assessment Protocol 2.1.1.
Airway Assessment/Management Protocol 2.1.2.
Attach cardiac monitor and pulse oximeter.
Transport to designated hospital.
7. SEVERE ALLERGIC
REACTIONS/ANAPHYLAXIS cont.
ALS LEVEL 1: PARAMEDIC ONLY
Initiate IV of Lactated Ringers or Normal Saline bolus with 250cc PRN up to 1 liter
(reassess vitals and respiratory status between each bolus), then rate of 125cc/hr.
(Bolus Peds with 20ml/kg then 40cc/hr).
Diphenhydramine HCL (Benadryl) 25mg IV or 50mg IM (Peds; 1-2mg/kg IV or IM).
Ranitidine (Zantac) 150mg PO (Peds; 2mg/kg PO).
Methylprednisolone Sodium Succinate (Solu-Medrol) 125mg IV/IO/IM.
Epinephrine (1:1000) 0.4mg IM Adult (Peds; 0.01mg/kg). Caution should be used
with administration of Epinephrine when the patient has a history of hypertension
or heart disease. Call Medical Control if you have any concerns.
IF patient is on a Beta Blocker medication, give Glucagon 2mg IV over 2-5 minutes.
If you are not sure which drugs are Beta Blockers, contact Medical Control to discuss.
If patient shows signs of respiratory distress, administer; Albuterol (Ventolin) 2.5mg
mixed with 2.5ml Normal Saline nebulizer treatment. May repeat twice PRN.
Add Atrovent (Ipratropium Bromide) 0.5mg to the first Albuterol nebulizer treatment
only.
If the nebulized treatments do not significantly resolve the respiratory distress,
consider the need for intubation.
8. SEVERE ALLERGIC
REACTIONS/ANAPHYLAXIS
ALS LEVEL 2: MEDICAL CONTROL
Epinephrine (1:10,000) 0.3mg SLOW IV in 0.1mg increments over 2 minutes.
Caution should be used with administration of Epinephrine if patient has history
of hypertension or heart disease.
9. Diphenhydramine (Benadryl)
Benadryl products work because they contain an ingredient called
diphenhydramine hydrochloride, which is an antihistamine.
Here’s what happens during an allergic reaction:
• The body releases a substance called histamine into the bloodstream.
• Histamine travels to various parts of the body such as the eyes, nose, or skin.
• Histamine causes blood vessels to widen and expand.
• This causes redness, swelling, and inflammation.
• Symptoms of itching, sneezing, runny eyes or nose, or hives arise.
• The antihistamine in Benadryl blocks the action of histamine in the body and
helps to quickly relieve the symptoms.
10. Methylprednisolone Sodium Succinate
(Solu-Medrol)
• Actions: Anti-inflammatory, suppresses immune response (especially in
allergic reactions).
• Indications: Moderate and Severe allergic reaction, anaphylaxis,
asthma/COPD.
• Precautions: Must be reconstituted and used promptly. Onset of action
may be 2-6 hours and thus should not be expected to be of use in the
critical first hour following an anaphylactic reaction.
11. RANITIDINE (Zantac)
Zantac is a antihistamine primarily effective for the
histamine receptors in your stomach. They're called h-2
receptors. The histamine receptors in your blood vessels &
nerve endings are primarily h-1 receptors with some h-2
receptors. When h-1 active antihistamines like Benadryl or
Allegra are not sufficient to control hives, ZANTAC can be
added for a little extra control. Alone, it's not very good.
12. Beta Blockers
Beta blockers, also known as beta-adrenergic blocking agents,
are medications that reduce your blood pressure. Beta blockers
work by blocking the effects of the hormone epinephrine, also
known as adrenaline. When you take beta blockers, the heart
beats more slowly and with less force, thereby reducing blood
pressure. Beta blockers also help blood vessels open up to
improve blood flow.
14. Glucagon
Glucagon bypasses the receptors obstructed by the beta-
blockers. These patients often respond poorly to epinephrine. In
case of epinephrine failure, consider the use of glucagon in
these patients.
Class: Hormone (anti-hypoglycemic agent).
Actions: Causes breakdown of glycogen to glucose.
Inhibits glycogen synthesis.
Elevates blood glucose level.
Increases cardiac contractile force.
Increases heart rate
15. Epinephrine 1:1,000
Epinephrine is a chemical that narrows blood vessels and opens
airways in the lungs. These effects can reverse wheezing, severe
skin itching, hypotension, hives and other severe allergic
reaction symptoms.